Provider Demographics
NPI:1356978589
Name:BUGG-WRENN, PAULA (MD)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:BUGG-WRENN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:
Other - Last Name:BUGG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:303 PARKWAY DRIVE NE
Mailing Address - Street 2:4TH FLOOR 4W
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312
Mailing Address - Country:US
Mailing Address - Phone:404-642-4183
Mailing Address - Fax:
Practice Address - Street 1:303 PARKWAY DRIVE NE
Practice Address - Street 2:4TH FLOOR 4W
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312
Practice Address - Country:US
Practice Address - Phone:404-642-4183
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program